Tandi Shamallah

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LP61569561 Issued in WA

Practice address

1909 104TH Ave E Unit Q304
Edgewood, WA 98372-1674

Phone

(425) 616-6267

NPI assigned

Jul 14, 2026

Last updated

Jul 14, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Tandi Shamallah Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1783987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1912826959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 104TH AVE E UNIT Q304",
            "city": "EDGEWOOD",
            "state": "WA",
            "postal_code": "983721674",
            "telephone_number": "425-616-6267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 104TH AVE E UNIT Q304",
            "city": "EDGEWOOD",
            "state": "WA",
            "postal_code": "983721674",
            "telephone_number": "425-616-6267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMALLAH",
        "first_name": "TANDI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-07-14",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "LP61569561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TANDI",
            "last_name": "SHAMALLAH",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Licensed Practical Nurse in Edgewood, WA
• Providers in Edgewood, WA by specialty
• Licensed Practical Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.